Pulmonary HTN - Clark Flashcards
acute PE is the ____ most common cause of ____ death
3rd most common cause of hospital-related death
what % of acute DVT self-resolve?
75%
what are the most common symptoms of PE
dyspnea > pleuritic CP > calf/thigh pain> cough/wheeze
what tests should you order to rule out PE
ABG, B-type Natriuretic peptide, troponin, EKG, CXR, CT PA
what is the gold standard for PE diagnosis
CT pulmonary angiography
what are possible treatment for PE
anticoag, thrombolytic, sx embolectomy, catheter
what is the treatment for life-threatening PE
pressor, inotrope, NO, RVAD, ECMO
post discharge PE therapy
- anticoagulation (3mo if reversible cause)
2. follow up echo in 3-6 mo for large PE or PHTN
what is the definition of PHTN
mean pulmonary arterial pressure > 25mmHg
what are the 5 different groups of PHTN
- pulmonary arterial HTN
- pulmonary venous HTN
- PHTN from lung disease
- chronic thromboembolic PHTN
- PHTN with unclear mechanisms
how do you diagnose PHTN
ECHO, V/Q, PFTs, right heart cath (definitive diagnosis)
what is the vasodilator challenge used for?
- determine the group or type of PHTN
- positive test: mean PAP
for what group can CCB be used as treatment for?
Only for group 1 - those who respond to the vasodilator challenge
What are other group 1 treatments
PDE-5 inhibitor, Prostacyclin, endothelin receptor agonist
*adjunct: NA restriction, diuretics, oxygen, rest, anticoagulation
Treatment for groups 2-5
2: treat left heart disease
3: pulmonary vasodilator
4: pulmonary thromboendarterectomy
5: no specific therapy
* remember that it is the right heart failure that kills these pts eventually
